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Updated: Jul 4, 2025

Adaptable Angled Stereotactic Approach for Versatile Neuroscience Techniques
Published on: May 7, 2020
Stereotactic Frame-Based Electrode Insertion: The Accuracy of Increasingly Oblique Insertion Angles
Zachary D Gilbert1, Austin M Tang, Terrance Peng
1University of Southern California, Keck School of Medicine of USC, Department of Neurological Surgery, Los Angeles, CA, United States.
Aim:
To investigate the relationship between planned drill approach angle and angular deviation of the stereotactically placed intracranial electrode tips.
Material And Methods:
Stereotactic electrode implantation was performed in 13 patients with drug resistant epilepsy. A total of 136 electrodes were included in our analysis. Stereotactic targets were planned on pre-operative magnetic resonance imaging (MRI) scans and implantation was carried out using a Cosman-Roberts-Wells stereotactic frame with the Ad-Tech drill guide and electrodes. Post implant electrode angles in the axial, coronal, and sagittal planes were determined from post-operative computerized tomography (CT) scans and compared with planned angles using Bland-Altman plots and linear regression.
Results:
Qualitative assessment of correlation plots between planned and actual angles demonstrated a linear relationship for axial, coronal, and sagittal planes, with no overt angular deflection for any magnitude of the planned angle.
Conclusion:
The accuracy of CRW frame-based electrode placement using the Ad-Tech drill guide and electrodes is not significantly affected by the magnitude of the planning angle. Based on our results, oblique electrode insertion is a safe and accurate procedure.

